ADHD and Alcohol Use Disorder: Understanding the Link
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ADHD and alcohol use disorder (AUD) share a significant genetic overlap, according to a 2021 review, with genes that make people more impulsive and lead to a maladaptive reward system present in both conditions.
ADHD is less recognized in people with AUD because alcohol can mask the symptoms, so people may unknowingly self-medicate with alcohol.
What does ADHD do in the brain?
ADHD specifically affects dopamine and norepinephrine, making it difficult for people with ADHD to pay attention and focus, control their impulses, stay organized, maintain motivation, and regulate their behavior, emotions and thoughts. People with ADHD are more impulsive, making it harder for them to delay gratification and resist triggers or urges, and they can use alcohol to treat their restlessness and make them feel more calm and focused.
Alcohol damages the brain and changes the way it functions, which can worsen ADHD symptoms.
Why ADHD increases the risk of AUD
Having ADHD increases the risk of developing AUD, and studies have found that treating the symptoms in childhood and teen years lowers the risk of developing AUD later in life. People with ADHD who do not have AUD are more sensitive to the effects of alcohol, so alcohol can feel more rewarding for them.
The attention dysregulation that occurs in people with ADHD can lead to increased attentional bias, which is when your thoughts get stuck on alcohol and you have trouble redirecting. Studies have found that people with ADHD who drink alcohol are more likely to keep drinking as they become more intoxicated. The more they focus on alcohol, the harder it is to divert their thoughts and focus from it, making it easier to relapse.
If you are struggling with ADHD symptoms, it's best to talk to your doctor or therapist and not try to self-diagnose or continue to attempt to manage your symptoms with alcohol.
Learn more about the link between ADHD and alcohol use disorder in episode 145
What to listen to next:
E48: is addiction genetic?
E62: dopamine deep dive
E128: why cravings are so powerful
E125: why you have no off-switch
E77: are NA drinks ok to drink?
Sources:
Mannuzza, S., Klein, R.G., Truong, N.L., Moulton, J.L., 3rd, Roizen, E.R., Howell, K.H., Castellanos, F.X., 2008. Age of methylphenidate treatment initiation in children with ADHD and later substance abuse: prospective follow-up into adulthood. The American journal of psychiatry 165.
Roberts W, Fillmore MT, Milich R. Drinking to distraction: does alcohol increase attentional bias in adults with ADHD? Exp Clin Psychopharmacol. 2012 Apr;20(2):107-17.
Luderer, M. Alcohol use disorders and ADHD. Neuroscience & Behavioral Reviews. 2021.
Hoogman M, Bralten J, Hibar DP, et al. Subcortical brain volume differences in participants with attention deficit hyperactivity disorder in children and adults: a cross-sectional mega-analysis [published correction appears in Lancet Psychiatry. 2017 Jun;4(6):436]. Lancet Psychiatry. 2017;4(4):310-319.
